The Double-Edged Sword of Stigma-Reduction

I am taking an abnormal psychology class this quarter and its pretty terrible which makes me angry and frustrated and sad (and we haven’t even gotten to eating disorders yet!). A large portion of the curriculum seems to be dedicated to reducing stigma around mental illness. Which is great (although not really what I think an abnormal psych class should focus on). Its the way the professor is going about it that is getting me all stabby. Like many other mental illness awareness/stigma-reduction campaigns the focal point seems to be the idea that mental illness is not that different from normal emotional experiences  and therefore that people who suffer from mental illness are just like everyone else and that everyone can understand what having a mental illness is like.

JUST NO.

Mental illness is not just an extreme version of normal emotion and behavior. Yes, sometimes the outwardly visible symptoms of a mental illness can appear as exaggerated versions of normal behaviors but the emotional experience of the sufferer cannot be understood in those terms. Eating disorders may look like extreme dieting behavior but let me assure you having an eating disorder IS NOT in any way like the experience of dieting. You cannot take the experience of a non-eating disordered person who diets and has “normal” body image issues and multiply it by any order of magnitude and get the experience of an eating disorder. Depression is not just feeling extra sad. Anxiety disorders are not just feeling extra worried. I believe this holds true for all mental illnesses.

Now the issues of whether people with mental illnesses are just like everyone else and can lead completely normal and successful lives is a little more nuanced. I absolutely believe that with good treatment most people can go into remission from their mental illness. I like to think that I am living proof of that. My life looks – and for the most part is – very normal. And yet for many years I was completely unable to function in any way that resembled normality – unable to hold down a job, stay in school, have relationships, feed myself properly, at times unable to even get out of bed and get dressed. And for some people with mental illness, their lives may never get back to normal. When we harp on and on about the idea that people with mental illness can be totally “normal”, what are we implying about the mentally ill people who can’t? That if they just tried harder they could overcome their illness! and be normal!? To me it just reeks of victim-blaming. Because, honestly, the difference between me and the homeless, schizophrenic man on the street corner is not that big. My parents were willing and able to pay for airplane tickets home from South America and pay rent on apartments when I couldn’t. They did a lot of things wrong but they never told me I couldn’t come home. That’s all. That is the difference. There are moments I think back on when, without that financial support, without a home to come back to when I had nowhere else to go, I would have ended up on the streets, on drugs, psychotically depressed, doing god knows what. The people for whom that becomes the reality do not deserve to be thrown under the bus in the name of making the general public feel more comfortable with mental illness. These people do not deserve to have the burden of the stigma thrown entirely on their shoulders for the benefit of those of us lucky enough to come out the other side and be able to pass as “normal”.

So, no, I do not believe that people who have not experienced mental illness can truly understand what it is like. For some reason that is not entirely clear to me, this seems to be a belief that offends a lot of people. I am not saying they have never experienced anything painful or hard. I am not saying that they cannot learn about mental illness and effectively support people who do suffer. I am not saying that they cannot become wonderful, compassionate clinicians. I am not saying that loving someone with a mental illness is not a challenging and painful experience in and of itself. What I am saying is that YOU DO NOT KNOW WHAT IT IS LIKE. And that’s ok.

We do not talk about other illnesses in this way. People do not claim to understand what it is like to have cancer because something bad happened to them once. We do not conceptualize cancer as a really really exaggerated version of the flu. We do not think that our ability to treat people with physical illnesses with compassion is tied to our ability to relate to their experience. Treating physical illness or supporting someone who is ill does not require us to KNOW exactly what they are going through. We need to stop doing this with mental illness. We need to encourage an educated and compassionate view of mental illness that is not relient upon this idea that its “not that different”.